Archive for the ‘Mechanical Ventilation’ Category

We demonstrated an increase in hospital LOS, increased hospital costs, and a trend toward increased hospital mortality in VRE+ patients compared with VRE— patients. VRE colonization previously has been associated with longer hospital stays, which is suggestive of increased exposure to VRE. In this study, although VRE colonization was associated with prolonged hospital stays, this […]

The five patients who were VRE+ on arrival to the medical ICU had a significantly higher incidence of neutropenia compared with VRE— patients. In addition, all 13 patients who were colonized with VRE had a significantly higher incidence of immunosuppression and neutropenia compared with patients who were not colonized with VRE. Although previous studies have […]

In the mid-1980s, the first clinical isolate of VRE was discovered in Europe. Since that time, VRE has become a prominent organism both in Europe and, more recently, in the United States. Documented infections may represent a “tip of the iceberg” phenomenon with a large reservoir of colonized patients in critical care units and other […]

Three of 29 patients converted from VRE— to VRE+ while intubated at some time during their stay in the ICU. The baseline characteristics of these patients and the characteristics of their ICU stay compared to the other patients with subsequent rectal cultures that remained negative are shown in Table 3. Interestingly, the patients with VRE […]

One hundred twenty-three rectal cultures were obtained from 83 patients; 67 cultures were obtained on day 1, 33 on day 3 or 4, 19 on day 6 or 7, and 8 on day 8. Of the 67 cultures obtained on day 1, VRE was isolated from 5. Twenty-nine patients who initially had rectal cultures negative […]

Baseline demographic data, prior antibiotic usage, and previous location of care or residence were recorded for each patient on admission to the ICU. In addition, hospital length of stay (LOS), ICU LOS, and hospital cost were determined. Patients were classified as immunocompromised if they had AIDS, solid organ transplantation, solid organ malignancies undergoing chemotherapy or […]

Surveillance for VRE infections at our own hospital identified only 15 cases in 2,100 admissions to two medical ICUs from 1995 to 1996. Nonetheless, as part of a study of prevention of ventilator-associated pneumonia, we decided to prospectively collect rectal cultures to determine the incidence of VRE colonization in our patients undergoing mechanical ventilation. In […]

Strains of vancomycin-resistant enterococcus (VRE) are prominent emerging nosocomial pathogens in the United States. Treatment of these organisms is difficult because they typically are resistant to multiple antibiotics, including penicillins and aminoglycosides. Enterococci are now the second most common organism isolated from sites of nosocomial infection in the United States, with a seeming increase in the […]